August 20th, 2018

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Clinical Complications of Cesarean Delivery During Primary Herpes Simplex Virus Infection: A Case Report
Authors:  Sneha Shahane, M.D., Brennan C. Lang, M.D., and Steven L. Clark, M.D.
BACKGROUND: Herpes simplex virus–1 infection (HSV-1) as a cause of postpartum sepsis has not been reported. We present a case of primary disseminated maternal HSV-1 in the perioperative period resulting in life-threatening complications.

CASE: An 18-year-old woman developed sepsis on day 11 following cesarean delivery. Her neonate expired the previous day from disseminated HSV-1 infection. Maternal HSV-1 sepsis was confirmed by antibody titers and serum quantitative PCR. Despite acyclovir therapy, the patient continued to have fevers with persistent loculated pelvic and abdominal fluid collections. Surgical extirpation of the loculated lesions resulted in rapid clinical defervescence.

CONCLUSION: Disseminated HSV should be considered as a cause of unresponsive postpartum sepsis, even in the absence of detected mucocutaneous lesions. Cesarean delivery should be avoided with concurrent primary HSV infection.
Keywords:  herpes simplex virus, pregnancy, viral sepsis
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